No. 216.] 395 



The desire which stimulated me in former days was, however, not 

 suffered to sleep in my bosom j a year's reflection, and daily and 

 more extended observation, have not only confirmed my confidence 

 in the feasibility, but increased the conviction of the necessity, of the 

 measure 1 bad proposed, and they have enabled me to modify, en- 

 large and illustrate the plan, while the determination displayed by 

 the new chief magistrate to do his share of the reforms promised, 

 has inspired me afresh with the hope that the present might be .a 

 favorable time for a renewed presentation of my favorite design. 



It is a measure of Sanitary Reform. It is designed to relieve 

 the city of a part of the heavy burden of sickness and mortality, 

 which now oppresses its population, more especially that portion 

 least able to relieve themselves, and most requiring the mterposition 

 and protection of law. It will be seen to be a measure of humanity, 

 of justice to the poor, of safety to the whole people, and of economy 

 to the public treasury. 



The objects of this communication, briefly stated, are these; — 1st, 

 to show that there is an immense amount of sickness, physical disa- 

 bility, and premature mortality, among the poorer classes; — 2d, that 

 these are, to a large extent, unnecessary, being in a great degree the 

 results of causes which are removable; — 3d, that these physical evils 

 are productive of moral evils of great magnitude and number, and 

 which, if considered only in a pecuniary point of view, should arouse 

 the government and individuals to a consideration of the best means 

 for their relief and prevention; and 4th, to suggest the means of 

 alleviating these evils and preventing their recurrence to so great an 

 extent. 



Before proceeding to the explanation of the subject, it is necessary 

 to understand the distinction between Public Health and Individual 

 Health. In some senses these are different, in others they are similar, 

 and have an intimate connexion. The difference depends chiefly on 

 the cause being personal or general. Thus an individual may be 

 made sick by causes which affect no one else, as in dyspepsia, oph- 

 thalmia, rheumatism, &c., and yet even these diseases, personal and 

 peculiar as they seem to be, will sometimes be found dependent upon 

 causes which affect large numbers at the same time. For instance, 

 the well water, v..hich we have heretofore been obliged to drink, 

 was the frequent cause of dyspepsia, and some other complaints. 

 Ophthalmia sometimes prevails extensively in asylums and hospitals^ 

 and at the Long Island farms it has several times proved a scourge. 



